Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | L5956 | TX |
Y | 2080N0001X | Neonatal-Perinatal Doctor | D75544 | MD |
N | 2080N0001X | Neonatal-Perinatal Doctor | L5956 | TX |
NPI | 1013953579 |
---|---|
Provider Name | Mesfin Woldesenbet |
First Address | Beltsville, MD 20705-1187 |
Second Address | Rockville, MD 20850 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 18/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
163136803 | (05) | TX |
163136804 | CSHCN (01) | TX |
8K9797 | BCBS (01) | TX |
I28165 | (02) | TX |